Evaluating injuries and illnesses that occurred during the Yukon Quest International sled dog race, 2018-2020

Introduction

The purpose of this study was to evaluate medical record data from the 2018-2020 Yukon Quest International Sled Dog race to examine injury patterns and risk factors for dogs competing in multi-day ultra-endurance events. Specifically, we summarized injuries and illnesses that resulted in canine athletes being removed ("dropped") from competition, and in orthopedic injuries diagnosed in both dropped and finished dogs.

Methods

The records of 989 dogs that started the race were examined, but only records from dogs in teams that went on to finish the race were included, for a total of 711 records.

Results and discussion

Three hundred and sixty five dogs (51.3%) were noted to have at least one abnormal finding in their veterinary medical record during the race. Orthopedic injuries were most common, and 291 injuries were ultimately diagnosed in 234 dogs (32.9%). Ultimately, 206 dogs (29%) were dropped from competition, for any reason. The most common reasons for dropping dogs were orthopedic injuries (156 dogs; 188 injuries), gastrointestinal illness (22 dogs), and cardiorespiratory disease (7 dogs). Most orthopedic injuries in dropped dogs occurred in the thoracic limb (n = 121 dogs; 151 injuries). Of those, injuries to the shoulder were most common (n = 77), followed by injuries to the carpus (n = 59), and injury to the pelvic limb (n = 32). Carpal injuries were the most prevalent injury diagnosed in dogs that went on to finish the race (71 of 85 injuries). Carpal injuries were the most prevalent injuries overall in 2018 (51%) and 2019 (52%). In 2020, shoulder injuries were most prevalent (27%), suggesting that trail conditions may have differed between years. The majority of dogs with an orthopedic injury ultimately were removed from competition (156 of 234, or 66.6%), but the likelihood of finishing the race with an injury depended on the type of injury sustained; 71 of 130 dogs (54.6%) with a carpal injury went on to finish the race, whereas only 9 of 86 dogs with a shoulder injury (10.5%) went on to finish. The results of this study can assist mushers and veterinarians in preparing for races, and in decision making during endurance sled dog races.

Is the Rivermead Post-Concussion Symptoms Questionnaire a Reliable and Valid Measure to Assess Long-Term Symptoms in Traumatic Brain Injury and Orthopedic Injury Patients? A Novel Investigation Using Rasch Analysis

Persistent post-concussion syndrome (PCS) symptoms are known to last years after traumatic brain injury (TBI), and similar symptoms are increasingly being documented among those who have not experienced a TBI. There remains however, a dearth of empirical evidence on the structural composition of symptoms beyond the post-acute symptom phase after TBI, and little is known about the potential use of PCS symptom scales to measure PCS-like symptoms in non-TBI individuals. Our objective was therefore to examine the psychometric performance and dimensionality of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) as a measure of long-term PCS symptoms among a TBI and non-TBI sample. A case-control sample of 223 patients with injury, consisting of age- and sex-matched TBI participants (n = 109) and orthopedic participants (n = 114) were recruited from a regional trauma registry in New Zealand (NZ), and assessed at mean 2.5 years post-injury. Results from the Rasch analysis showed that the RPQ achieved fit to the Rasch model, demonstrating very good reliability (Person Separation Index [PSI] = 0.87), thereby indicating that the measure can be used reliably for individual and group assessment of symptoms among both TBI and orthopedic patients. In this study we demonstrated evidence of a unidimensional construct of PCS symptoms in both groups, which helps alleviate previous uncertainty about factor structure, and permits the calculation of a total RPQ score. Conversion of ordinal to interval total scores presented within are recommended for clinicians and researchers, to improve instrument precision, and to facilitate the interpretation of change scores and use of parametric methods in data analysis.

Distracted Driving on YouTube: Categorical and Quantitative Analyses of Messages Portrayed

BACKGROUND

Distracted driving is a global epidemic, injuring and killing thousands of people every year. To better understand why people still engage in this dangerous behavior, we need to assess how the public gets informed about this issue. Knowing that many people use the internet as their primary source of initial research on topics of interest, we conducted an assessment of popular distracted driving videos found on YouTube.

OBJECTIVE

This study aimed to gauge the popularity of distracted driving videos and to assess the messages portrayed by classifying the content, context, and quality of the information available on YouTube.

METHODS

We conducted a search on YouTube using 5 different phrases related to distracted driving. Videos with more than 3000 views that mentioned or portrayed any aspect of distracted driving were identified, collected, and analyzed. We measured popularity by the number of videos uploaded annually and the number of views and reactions. Two independent researchers reviewed all the videos for categorical variables. Content variables included distractions; consequences; orthopedic injuries; and whether the videos were real accounts, reenactments, fictitious, funny, serious, and graphic. Context variables assessed the setting of the events in the video, and quality of information was measured by the presence of peer-reviewed studies and inclusion and referencing of statistics. Discrepancies in data collection were resolved by consensus via the coding authors. A comparative subanalysis of the 10 most viewed videos and the overall results was also done.

RESULTS

The study included a total of 788 videos for review, uploaded to YouTube from 2006 to 2018. An average of 61 videos with greater than 3000 views were uploaded each year (SD 34.6, range 3-113). All videos accumulated 223 million views, 104 million (46.50%) of them being among the 10 most viewed videos. The top 3 distractions depicted included texting, talking on the phone, and eating and/or drinking. Motor vehicle crashes (MVCs) and death were depicted in 742 (94.2%) videos, whereas 166 (21.1%) of the videos depicted injuries. Orthopedic injuries were described in 90 (11.4%) videos. Furthermore, 220 (27.9%) of the videos contained statistics, but only 27 (3.7%) videos referenced a peer-reviewed study.

CONCLUSIONS

This study demonstrates that there is a high interest in viewing distracted driving videos, and the popularity of these videos appears to be relatively stable over time on a forum that fluxes based on the current opinions of its users. The videos mostly focused on phone-related distractions, overlooking many other equally or more common forms of distracted driving. Death, which in reality is a far less common distracted driving consequence than injuries, was portrayed 1.7 times as much. Surprisingly, orthopedic injuries, which lead to a massive source of long-term disability and often result from MVCs, are vastly underrepresented.

Key components and potential benefits of a comprehensive approach to women's musculoskeletal health

Over the last 40 years there has been a significant increase in the number of female athletes, as well as a rise in musculoskeletal injuries observed in women. There is sufficient evidence from past medical research identifying various musculoskeletal injuries and conditions that more commonly affect women, such as osteoarthritis, osteoporosis, stress fractures, and anterior cruciate ligament tears. Several women's sports medicine and musculoskeletal health programs have been developed throughout the United States in an attempt to provide more tailored care to the female athlete. The goal of a comprehensive approach to women's musculoskeletal health is to create an interdisciplinary team to facilitate treatment for a variety of injuries and related conditions. This manuscript outlines the musculoskeletal conditions that commonly affect women and highlights the various etiologies of these sex disparities. We discuss the role of interdisciplinary women's musculoskeletal health and sports medicine programs, and define the potential benefits of such an approach. Future studies should focus on assessing the outcomes of multidisciplinary women's sports medicine programs as current literature in this area is lacking.

Geriatric High-Energy Polytrauma With Orthopedic Injuries: Clinical Predictors of Mortality

Background:

The impact of orthopedic injuries in the elderly patient with multi-trauma and the effect of operative fixation on these injuries have not been thoroughly evaluated.

Methods:

We reviewed geriatric patients (aged 65 and older) between 2004 and 2010 at a level 1 trauma center who sustained high-energy polytrauma (injury and severity score [ISS] ≥ 16) with associated orthopedic injuries. Patients were excluded if they had severe head and spine injuries, died on arrival, or had low-energy mechanisms of injury. Logistic regression was conducted to identify factors that predict mortality.

Results:

There were 154 patients who comprised our study group with an average age of 76 years and an ISS of 23. There were 96 males and 58 females. Overall, 52 patients died within 1 year of their admission: 21 patients during their initial hospital stay and 31 patients within 1 year following admission. In all, 64 (42%) patients underwent operative stabilization of their orthopedic injuries. Increased mortality was seen (P < .05) in female patients, those with lower admission Glasgow coma score, and those who underwent orthopedic surgery. Patients had worse outcomes if they sustained femur (P = .014), clavicle, or scapular fractures (P = .027). Other factures associated with higher mortality included pelvic/acetabular injury requiring surgery (P = .019) or spine fractures treated nonoperatively (P = .014).

Conclusion:

The effect of orthopedic injuries on this geriatric polytrauma group contribute to worse outcomes when they included clavicle, scapula, and femur fractures. We also found that pelvic/acetabular fractures treated operatively and nonoperative spine fractures were associated with higher mortality rates. Risk/benefit consideration is suggested when contemplating operative intervention in these patients.

Epidemiological study of orthopedic injuries in hemodialysis patients in Taiwan: a fixed cohort survey, 2004-2008

BACKGROUND

The burden of chronic kidney disease (CKD) is a growing concern worldwide. The prevalence of hemodialysis in Taiwan is the highest in the world, and this may increase the prevalence of orthopedic fractures. The aim of this study was to explore the incidences of various orthopedic injuries and the related risk factors.

METHODS

A nationwide prospective study based on the Taiwan National Health Insurance dataset was conducted during 2004-2008. A total of 82,491 CKD patients were selected as the fixed cohort population. The International Classification of Diseases 9-CM diagnosis codes and treatment codes were identified as the inclusion criteria for orthopedic injury.

RESULTS

A total of 82,491 Taiwanese people with CKD were identified in 2004, and 4915 orthopedic injuries occurred during the 5-year follow-up period. The cumulative incidences of orthopedic injuries were 42.56‰ for lower limb fractures, and 12.93‰, 3.27‰, and 1.64‰ for upper limb fractures, vertebrae fractures, and joint dislocations, respectively. All three types of orthopedic fractures were more common in the oldest age stratum (≥65 years old). In the CKD patients, the risk ratio of osteoporosis was 3.47 (95% confidence interval, 3.10-3.89) for all orthopedic injuries. Patients of advanced age, the female gender, and those with high comorbidity were also at significant risk of sustaining orthopedic fractures.

CONCLUSION

The results from this Taiwanese CKD cohort support the strong influence of aging and osteoporosis on all kinds of orthopedic injuries. The postponing of osteoporosis may need to be taken into consideration for the prevention of orthopedic injury among CKD patients undergoing hemodialysis.